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Pathology law threatens practices Andrew Bracey PRACTICES could go out of business as a result of soaring costs if legislation governing leasing arrangements with pathology and diagnostic imaging providers comes into force. From I March, changes to the Health Insurance Act will mean practices deemed to be charging a~ market value for colocated services could face fines of up to $660,000 or five years in jail. Practices could be required to provide evidence to Medicare
that the rent they are charging is within 10% of acceptable market values. This would be determined by taking the average of evaluations by at least two independent valuers and comparing it to the cost charged. Practice management consultant David Oahm told Medical Ol>server this would create additional costs for practices with legal fees and leases having to be changed. "This could affect how much GPs are paid, reduce bulk-billing and push up patient fees, •
he said. Australian Association of Practice ManagetS (AAPMJ vice president Brett McPhetSOn said this could ultimately "jeopardise the viability of general practice services."
The AMA lodged a submission to the government expressing concerns about the legislation last week. The submission said it "should be up to the courts, not government, to determine if the rent paid by any party is grossly excessive or grossly undervalued so as to result in the provision
of an incenti~ to refer or provide. "The effect of this govetnmental price fixing will be to create an environment where pathology providers increase their net profits by obtaining cheaper rents than the free market provides. "More than likely [this] will discourage the co-location of medical services with pathology or diagnostic imaging services which would be in direct conflict with the government's proposed policy to improve access to a >page 4
GPs reject accreditation Andrew Bracey GPs are shunning practice accred· iration and forgoing incentives of up to $56,000, with government figures revealing as many as one in three general practices have refused to take it up. A Commonwealth report revealed just 65.7% of practices were accredited in 2007 - much lower than previous estimates from Australian General Practice Accreditation Limired (AGPAL) of 90 per cent. The latest Review of Government Services Provision report was bas~d on practice
numbers supplied by individual divisions which indicated there were 7356 general practices in Australia. It used accreditation figures from AGPAL and, for the first time, Quality Practice Accreditation. AGPAL told Medical Observer it would not challenge the report
and in light of the discrepancy would have to "revise" its numbers. Dr joe Kosterich, a Perth GP and former AMA Council of General Practice chair who lobbied against the introduction of accrediration on behalf of the profession, said the new figure meant practices refus· ing to accredit could no longer be ignored. "If one in three have decided by this stage they don't see it as worth· while going through, it means [the accrediration bodies! or tbe college need to actually engage with them and find out what they see as the problem so improvements can be made.•
ON DEEPER PALPATION Poverty is linked to physiological stress 23
The cost of accreditation cur-
rently starts at around $1100 per full·time equivalent GP, and govern· ment figures show that in 2005..()6 practices taking part in the Practice Incentives Program (PIP) received average payments of $56,000. >page 4
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